What's new in diabetes care
Introduction to diabetes
Types of diabetes
Diagnosis
Risk factors & screening

Macrovascular complications

• Large vessel disease
• Treatment options

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Large vessel disease

High blood glucose can also cause damage to the large blood vessels. In fact, diabetes mellitus is now being considered as "cardiovascular risk equivalent".

Therefore poorly controlled diabetes increases the risk of:

• Heart attack by 2 – 4 times

• Stroke by 4 – 6 times

• Peripheral vascular disease (leg pain on walking

Cardiovascular disease e.g. heart attack and stroke are uncommon in the pre-menopausal women. But if they have diabetes mellitus, the risk of cardiovascular disease is even higher when compared with the risk in men.

Treatment options

Measures to prevent macrovascular complications include

• Tight blood glucose control to the level to as near normal as possible
• Lifestyle modifications e.g. healthy eating with low sugar, low fat and low salt diet, and increased physical activity
• Stop smoking
• Control of blood pressure with target blood pressure <130/80 mmHg. Angiotensin Converting Enzyme inhibitors or Angiotensin Receptor Antagonists as drug of choice in those with concommitant microalbuminuria
• Treat abnormal lipids (dyslipidaemia) with appropriate lipid lowering drugs
• Start aspirin and other antiplatelet agents as studies have shown that anti-platelet agents reduce the cardiovascular events such as stroke and heart attack in patients with diabetes.